<!--
  ========================LICENSE_START=================================
  screenit-web
  %%
  Copyright (C) 2012 - 2020 Facilitaire Samenwerking Bevolkingsonderzoek
  %%
  This program is free software: you can redistribute it and/or modify
  it under the terms of the GNU Affero General Public License as published by
  the Free Software Foundation, either version 3 of the License, or
  (at your option) any later version.
  
  This program is distributed in the hope that it will be useful,
  but WITHOUT ANY WARRANTY; without even the implied warranty of
  MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  GNU General Public License for more details.
  
  You should have received a copy of the GNU Affero General Public License
  along with this program.  If not, see <http://www.gnu.org/licenses/>.
  =========================LICENSE_END==================================
  -->
<html xmlns:wicket="http://wicket.apache.org">
<wicket:panel>
    <div class="row-fluid form-horizontal">
        <form wicket:id="csvForm">
            <fieldset>
              <h1>Hpv bericht maken door middel van een CSV bestand</h1>
              <div class="row-fluid">
                    <div class="span3">
                        <div class="control-group">
                            <label for="bsn" class="control-label span2">Bestand:</label>
                            <div class="controls">
                                  <input type="file" wicket:id="fileUpload">
                            </div>
                        </div>
                    </div>
             </div>
              <div class="row-fluid">
                    <div class="span12">
                        <div class="form-actions clearfix">
                            <button class="btn btn-info" wicket:id="verstuurHl7Bericht">Verstuur HL7 bericht</button>
                        </div>
                    </div>
                </div>
            </fieldset>
        </form>
    </div>
</wicket:panel>
</html>
